Provider Demographics
NPI:1164482808
Name:ALLOTEY, PETER EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:EDWARD
Last Name:ALLOTEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5398 THOMASTON RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31220-8110
Mailing Address - Country:US
Mailing Address - Phone:478-743-8316
Mailing Address - Fax:478-743-1824
Practice Address - Street 1:5398 THOMASTON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31220-8110
Practice Address - Country:US
Practice Address - Phone:478-743-8316
Practice Address - Fax:478-743-1824
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00924624AMedicaid
GA11BDVBBMedicare ID - Type Unspecified
GA00924624AMedicaid